IMPLICIT AND EXPLICIT SPIRITUALITY IN THE LIVES OF TRANSGENDER AND GENDER-EXPANSIVE OLDER ADULTS

Abstract Religion and spirituality for transgender and gender expansive people (whom we refer to collectively as trans) are complicated by mainstream religions’ history of stigmatizing and marginalizing sexual and gender minorities. We conducted an interpretive content analysis of biographical interviews with 88 trans older adults from across the United States, applying six tenets of spiritual psychotherapy to their life narratives. Our findings suggest that some trans older adults’ spirituality is experienced both implicitly and explicitly. Implicit spirituality reflects the ways in which meaning, purpose, and connection in one’s life are nurtured with respect to one’s gender identity. Explicit spirituality reflects the process of consciously renegotiating one’s spiritual beliefs and religious practices to validate one’s gender identity and place in society. This knowledge is potentially helpful for gerontological practitioners who seek to nurture trans people’s spirituality and well-being as they age.

Mounting evidence suggests that the protective effects of one's own higher socioeconomic status (SES) on health is diminished among minoritized racial/ethnic groups in the United States (U.S.) with respect to outcomes such as mortality, hospitalization and mental health.Extending this area of research to childhood SES and later life outcomes, this study examines whether the protective effects of higher parental education on cognition is diminished among Black adults relative to their non-Hispanic White peers.Using data from the Health and Retirement Study, the Midlife in the U.S. Study, and the National Social Life, Health and Aging Project, I examine whether associations between parental education and two measures of cognition (episodic memory and global cognition) are moderated by race (non-Hispanic White or Black) using a random-effects individual participant data meta-analysis approach.I find evidence for a small, but robust, protective effect of higher parental education on both episodic memory and global cognition among White adults.Among Black adults, there was no association between parental education and neither episodic memory nor global cognition.This study provides evidence that the protective effect of higher parental education on cognition is not the same across racialized populations, consistent with the theory of Minority Diminished Returns.As scholars continue calls for life course-oriented efforts to reduce racialized cognitive disparities, it is important to consider early-life risk and protective factors in the context of structural racism.

DISPARITIES IN ELECTION, ACCESS, AND OUTCOMES IN MEDICARE END-OF-LIFE CARE: A NATIONAL STUDY
Thomas Christian 1 , Michael Plotzke 2 , Mariana Sarango Cancel 1 , Catherine Hersey 1 , and Zinnia Harrison 3 , 1. Abt Associates, Cambridge, Massachusetts, United States,2. Abt Associates,St. Louis,Missouri,United States,3. Abt Associates,Inc.,Rockville,Maryland,United States We examined whether end-of-life care racial disparities persist even within groups with similar geographic access and health care options.We reviewed calendar year (CY)2021 fee-for-service Medicare claims to determine if a beneficiary ever: elected hospice, had an end-of-life care conversation with their physician, and/or received advanced care planning services.We obtained beneficiary characteristics from Medicare administrative records and used Consumer Assessment of Health Providers and Systems Hospice star ratings to identify poorer quality hospices (one-or two-stars out of five).As a measure of the quality-of-care processes beneficiaries received, we calculated Hospice Visits in the Last Days of Life (HVLDL).Using logistic regression, we calculated Adjusted Odds Ratios (AORs) and 95% Confidence Intervals (CIs) to characterize the association between race/ ethnicity and end-of-life services utilization.Relative to white decedents, beneficiaries were less likely to elect hospice if they were black [AOR 0.67 95% CI 0.65-0.69],Asian [AOR 0.62 95% CI 0.59-0.66]or Hispanic [AOR 0.76 95% CI 0.72-0.81].Additionally, non-white beneficiaries more often received care from poorer quality hospices than the white beneficiaries residing in their same zip code (black AOR 1.26 95% CI 1.21-1.31,Asian AOR 1.21 95% CI 1. 14-1.29, Hispanic AOR 1.16 95% CI 1.09-1.24).In such poorer quality hospices, non-white beneficiaries have lower HVLDL rates (white 48.5%, black 40.3%, Asian 42.6%, Hispanic 45.8%).We found no substantial racial/ethnic disparities in recorded advance care plans or end-of-life conversations.CMS should continue to monitor trends in hospice utilization and ensure all beneficiaries receive equal and adequate care.The World Health Organization recently launched a global campaign to end ageism due to its widespread, insidious negative health impacts on older adults.Similarly, racism is a key driver of health disparities and has been declared a public health crisis by jurisdictions around the United States.While a strong literature summarizes coping theory in general as well as beneficial and maladaptive coping mechanisms among older adults, limited research describes how older adults cope with experiences of ageism and racism, particularly through an intersectional lens.The aim of this qualitative, phenomenological study was to understand how older adults cope with intersectional experiences of ageism and racism.Twenty adults 60+ residing in the U.S. Mountain West who identified as Black, Hispanic/Latino(a), Asian-American/Pacific Islander, Indigenous, or White participated in a one-hour, semi-structured interview.A team of five coders engaged in an inductive coding process through independent coding followed by critical discussion.Peer debriefing, member checking, and an audit trail enhanced credibility.Nine themes were identified: 1) resistance, 2) exhaustion, 3) acceptance/'let it go,' 4) avoidance, 5) increased awareness through aging, 6) help others, 7) educate others, 8) self-determination/defy stereotypes, and 9) healthy lifestyle.These themes exemplify problem-focused and emotionfocused, as well as individual and collective coping strategies.Novel findings include how older adults may cope with ageism and racism through helping peer older adults and via increased awareness through aging.Practitioners should recommend coping strategies which combine collective and problem-focused responses to ageism and racism such as resistance, helping others, and educating others.

Kansas, United States, 4. Washington University in St Louis, St. Louis, Missouri, United States
Religion and spirituality for transgender and gender expansive people (whom we refer to collectively as trans) are complicated by mainstream religions' history of stigmatizing and marginalizing sexual and gender minorities.We conducted an interpretive content analysis of biographical interviews with 88 trans older adults from across the United States, applying six tenets of spiritual psychotherapy to their life narratives.Our findings suggest that some trans older adults' spirituality is experienced both implicitly and explicitly.Implicit spirituality reflects the ways in which meaning, purpose, and connection in one's life are nurtured with respect to one's gender identity.Explicit spirituality reflects the process of consciously renegotiating one's spiritual beliefs and religious practices to validate one's gender identity and place in society.This knowledge is potentially helpful for gerontological practitioners who seek to nurture trans people's spirituality and well-being as they age.

University of Washington, Seattle, Washington, United States
The health-related pathways of bisexual individuals are most often compared to those of lesbians and gay men or examine participants of different genders separately.However, little is known regarding how the health-related pathways of bisexual individuals of diverse genders compare to one another, particularly in mid-to later life.This analysis examines identity-related and social factors which impact the mental health outcomes of midlife and older bisexual women, men and non-binary individuals and compares health-related pathways across genders.Analyses examined data from the National Health, Aging, and Sexuality/Gender Study (NHAS), including bisexual women (96), men (102), and non-binary individuals (16) ages 50+.The study utilized structural equation modeling to investigate direct and indirect associations between gender and mental health via sexual identity-related (victimization, negative identity perception, and outness) and social factors (LGBTQ community engagement).For both men and women, negative identity perception was associated with being less out, particularly among women.Bisexual men who reported more victimization also reported more negative identity perception.However, negative identity perception was associated with worse mental health only among women.Across genders, victimization negatively impacted mental health and identity outness increased community engagement.Community engagement mediated the relationship between identity outness and mental health among men.Findings indicate distinct mental health pathways across genders.Thus, mental health interventions might also differ.While LGBTQ community engagement might be particularly beneficial to bisexual men, bisexual women might struggle more with identity perception.Future research will benefit from larger subsamples, particularly among non-binary individuals.

SESSION 4200 (BIOLOGICAL SCIENCES INVITED SYMPOSIUM)
Abstract citation ID: igad104.1553SENESCENCE NEW FRONTIERS -SENNET CONSORTIUM Chair: Laura Niedernhofer Co-Chair: Viviana Perez Montes Senescence is a cell fate triggered by stress, activating signaling cascades that stably arrest the cell cycle, thereby preventing mutagenesis and cancer.Senescent cells are critical for wound healing and other physiological processes, during which they secrete a host of factors that remodel tissue and attract immune cells, which are responsible for removing the senescent cells.However, with age and immune dysfunction, senescent cells accumulate and are established to play a causal role in aging and most age-related diseases, largely through their secretome that drives chronic sterile inflammation.Senescent cells have proven tractable as drug targets, potentially affording novel geroscience approaches to treat a variety of age-related diseases, including Alzheimer's disease.To optimize this opportunity much more must be learned about senescent cells.This is a challenge as there are no specific biomarkers to detect or isolate senescent cells.Furthermore, senescent cells are anticipated to be highly heterogeneous based on cell lineage, the cause of senescence, their secretome, and tissue context.This challenge sparked the creation of the SenNet Consortium, an NIH Common Fund effort involving hundreds of scientists across the globe charged with creating a 4D atlas of senescent cells in 18 healthy human tissues across human lifespan, using mice and perturbations to inform the mapping.The speakers in this session will define the goals of SenNet, the scientific opportunities and challenges, the novel technologies applied, and the anticipated deliverables including large public datasets and innovative search and visualization tools.The Cellular Senescence Network (SenNet) Program was established in 2021 by the NIH Director's Office Common Fund with the goal of comprehensively identifying and characterizing senescent cells across human lifespan in numerous organs.Mapping senescent cells in mice was added in 2022 to leverage genetic and pharmacologic approaches to drive, report, and ablate senescence in vivo.Senescent cells are implicated in driving most if not all age-related chronic diseases as well as accelerated aging caused by chronic diseases and their treatments (e.g., cancer chemotherapy).Furthermore, therapeutics specifically targeting senescent cells (senotherapeutics) have been developed and are currently being tested in clinical trials for multiple disease and geriatric endpoints.Thus, identifying and characterizing senescent cells throughout human aging and disease states has the potential to significantly impact Andrew Steward 1 , Yating Zhu 2 , Carson De Fries 2 , Annie Zean Dunbar 3 , Miguel Trujillo 4 , and Leslie Hasche 2 , 1. University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States, 2. University of Denver, Denver, Colorado, United States, 3. University of Denver Graduate School of Social Work, Denver, Colorado, United States, 4. Utah Division of Multicultural Affairs, Salt Lake City, Utah, United States